GeriPal

DECEMBER 2, 2022

So on today’s podcast we invite four brilliant individuals to talk about their perspective on how to change how we as a society and health care system partner with individuals with dementia. She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

MAY 5, 2022

We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. Communication techniques we can use when talking to individuals with hearing loss. But individuals who have hearing loss, there’s several problems. How to screen for hearing loss.

IT 102

IT Screening Hospital Clinic 102

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. We’re doing a lot of interactive relationship building. See also the long list of disclosures in the JAMA Network Open study. ” They can coach you.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

Pamela Wible MD

JUNE 20, 2025

Characterized by cynicism, exhaustion, and reduced job satisfaction, physician burnout can lead to devastating personal and professional consequences, including strained relationships, substance abuse, early retirement, and even suicide. Wendy Dean and Simon Talbot with their landmark 2018 article, Physicians aren’t ‘burning out.’

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. What do different patient populations need? But watch out! Alex 01:06 Yeah, go in person.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

The Clinical Problem Solvers

FEBRUARY 8, 2023

Between 2007 – 2019, Black individuals experienced a higher death rate for opioid overdose deaths than any other racial or ethnic group. These narratives have vilified individuals who would benefit from comprehensive, person-centered substance use treatment, rather than incarceration and other adverse harms.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Who follows the patient once the cancer goes into remission? Why am I having difficulty with this patient? Why am I feeling frustrated with this patient?

Patients 73

Patients Clinic Patient-Centered Illness 73

GeriPal

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. The article we discuss today, also published in JAMA , addresses these two gaps. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. Important implications.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

NOVEMBER 2, 2023

First, we’ve invited Jerry Gurwitz to talk about his recently published article in JAMA titled The Paradoxical Decline of Geriatric Medicine as a Profession (while it’s not the most upbeat title for the future of geriatrics, Jerry sees it as a call to action). I was going to start off by asking Jerry about why he wrote the JAMA article.

Board-Certified 91

Board-Certified IT Community Medical Student 91

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. When I see a patient?

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 8, 2024

Panelists BJ Miller and Naomi Saks have no relationships to disclose. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. Alex: I wonder when we talk about it, because we’ll have links to both Eric Cassell’s argument, and we mentioned another article from Tate.

IT 137

IT Families Family Physicals 137

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. Eric: Which brings us to an article. Jessie: Exactly.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

MAY 18, 2023

There are some older adults in whom these are the correct drugs, either because of their particular clinical circumstances or because shared decision making and patient values and preferences. So we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Is this the right drug for this patient?”

Medical 97

Medical IT Patients Clinic 97

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis. This is Eric Widera. Alex 00:12 This is Alex Smith.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Rather, most of us live and make decisions in relationship to one another.

Families 98

Families Family Patient-Centered IT 98

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Would you also just mind mentioning kind of the JPSM article too?

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

APRIL 4, 2024

The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients. Widera and Smith have no relationships to disclose. Guest Laurie Dornbrand has no relationships to disclose.

Families 112

Families Family Patient-Centered IT 112

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. Gordon Alwasa.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. Storytelling Helps Hospital Staff Discover The Person Within The Patient. She was a heart failure patient. Because that really is what this is about. What’s in a story?

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

FEBRUARY 29, 2024

Widera and Smith have no relationships to disclose. Guest hosts Lynn Flint and Anne Kelly have no relationships to disclose. The ones who are publishing interesting articles are easy as we knew MAID is always going to be a controversial topic. Alex: And, I like Diane Meyer’s “Matching treatment to patient goals.”

IT 126

IT Patient-Centered Illness Education 126

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? She was a heart failure patient. But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No Alex: It’s a great choice.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Ivermectin to treat cancer. Stem cell treatments.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

OCTOBER 5, 2023

We’ve invited Jacqueline Kruser and Bob Arnold on this week’s podcast to talk about their recently published JAMA Viewpoint article titled “ Reconsidering the Language of Serious Illness. ” You recently published an article in the New Yorker titled, I can’t even read my own, what was the title again? This is Eric Widera.

Illness 136

Illness IT Patient-Centered Families 136

GeriPal

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. I loved the relationship that we developed and the fun we had.

IT 104

IT Patient-Centered Families Family 104

GeriPal

APRIL 13, 2023

But, should we as clinicians care about the social lives of our patients? Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? But then recognizing that our relationships impact our health even outside the context of stress.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

MARCH 7, 2024

Check out the Pub Crawl GeriPal post for more info, and follow #HPMParty on Twitter to keep us as we crawl! ** In the last several years, I’ve seen more and more articles about end-of-life doulas ( like this NY Times article from 2021 ). But in the end, I see these as my patients and I’m trying to define what is the right model.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. The article was titled, “ Change is coming ” – which also gives you a hint as to today’s song request. I probably should have said GFR. Eric: Yes. I just choose GFR.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. Some of them are really deeply individual experiences. Kate 01:09 Yeah.

Patient-Centered 67

Patient-Centered IT Individual Screening 67

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. What are the patients that we remember?

IT 83

IT Families Family Illness 83

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

AUGUST 17, 2023

However, as noted in our editorial published with the donanemab trial , the modest benefits of amyloid antibodies would likely not be questioned by patients, clinicians, or payers if amyloid antibodies were low risk, inexpensive, and simple to administer. I think geriatricians seed to decide whether they want to get on board as individuals.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

MAY 12, 2022

He is also author of the book, “ Walk with the Weary: Lessons in Humanity in Health Care ,” and was featured in this Atlantic article. And then there are a number of groups that go out in vans and cars and go out into the surrounding community of Kerala to provide care for patients who are in their homes.

Community 115

Community IT Relationship Healthcare 115

GeriPal

AUGUST 31, 2023

You’re a senior author on this article in JPSM, where you interviewed some geriatricians and other people caring for older adults, nurse practitioners, social workers, et cetera. One colleagues of mine in the Netherlands did just interviews with 30 cancer patients and this theme kept coming out. We could have talked for hours!

Illness 128

Illness IT Diagnose Medical 128

GeriPal

JANUARY 20, 2023

But if you want to learn more, check out these links: The report by NASEM titled “ The National Imperative to Improve Nursing Home Quality ” The website for the Moving Forward We will also link to the JAGS articles co-authored by seven committee members that focus on specific recommendations of the NASEM report when they get published (stay tuned).

Finance 95

Finance Board-Certified IT Provider 95